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关节内脉冲射频与关节内皮质类固醇注射治疗颈椎小关节疼痛的比较。

Comparison of Intraarticular Pulsed Radiofrequency and Intraarticular Corticosteroid Injection for Management of Cervical Facet Joint Pain.

机构信息

Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Korea.

Yeungnam University School of Medicine and College of Medicine, Korea.

出版信息

Pain Physician. 2017 Sep;20(6):E961-E967.

Abstract

BACKGROUND

Disorders of the facet joints are some of the most common sources of chronic spinal pain. Facet joint pain is responsible for approximately 50% of patients with chronic neck pain. Pulsed radiofrequency (PRF) stimulation, after placing needle electrodes into the joint space, has been recently reported for the management of joint pain.

OBJECTIVE

The aim of this study was to evaluate the effect of intraarticular (IA) PRF for the management of cervical facet joint (CFJ) pain. In addition, we compared the effect of IA PRF to IA corticosteroid injection.

STUDY DESIGN

Prospective observational study.

SETTING

University hospital.

METHODS

Forty patients with CFJ pain were included in the study and randomly assigned to one of 2 groups: the IA PRF group and the IA corticosteroid (ICI) group. There were 20 patients in each group. Pain intensity was evaluated using a numeric rating scale (NRS) at pre-treatment, and one, 3, and 6 months after treatment.

RESULTS

When compared to the pretreatment NRS scores, patients in both groups showed a significant decrease in NRS scores at one, 3, and 6 months after treatment (P = 0.000). Changes in the NRS scores over time were not significantly different between the groups (P = 0.227). Six months after treatment, 10 patients (50.0%) in the PRF group and 12 patients (60.0%) in the ICI group reported successful pain relief (pain relief of = 50%).

LIMITATIONS

A small number of participants.

CONCLUSION

IA PRF stimulation is as effective as IA corticosteroid injection in attenuating CFJ pain. The use of PRF could decrease CFJ pain, while avoiding the adverse effects of steroids.Key words: Cervical facet joint pain, pulsed radiofrequency, intraarticular stimulation, chronic pain, corticosteroid injection, numeric rating scale.

摘要

背景

关节突关节紊乱是慢性脊柱疼痛最常见的原因之一。关节突关节疼痛约占慢性颈痛患者的 50%。在关节间隙中放置针电极后,最近有报道称脉冲射频(PRF)刺激可用于治疗关节疼痛。

目的

本研究旨在评估关节内(IA)PRF 治疗颈椎小关节(CFJ)疼痛的效果。此外,我们比较了 IA PRF 与 IA 皮质类固醇注射(ICI)的效果。

研究设计

前瞻性观察性研究。

设置

大学医院。

方法

将 40 例 CFJ 疼痛患者纳入研究,并随机分为 IA PRF 组和 IA 皮质类固醇(ICI)组,每组 20 例。在治疗前、治疗后 1、3 和 6 个月评估疼痛强度,使用数字评分量表(NRS)进行评估。

结果

与治疗前 NRS 评分相比,两组患者在治疗后 1、3 和 6 个月时 NRS 评分均显著降低(P = 0.000)。两组间 NRS 评分随时间的变化无显著差异(P = 0.227)。治疗后 6 个月,PRF 组 10 例(50.0%)和 ICI 组 12 例(60.0%)患者报告疼痛缓解良好(疼痛缓解率 = 50%)。

局限性

参与者人数较少。

结论

IA PRF 刺激与 IA 皮质类固醇注射一样,可有效减轻 CFJ 疼痛。使用 PRF 可以减轻 CFJ 疼痛,同时避免类固醇的不良反应。

关键词

颈椎小关节痛、脉冲射频、关节内刺激、慢性疼痛、皮质类固醇注射、数字评分量表。

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